10D2012355 CLIA NUMBER - WALGREENS CO

Laboratory Demographics

  • CLIA Code: 10D2012355
  • Facility Name: WALGREENS CO
  • Facility Address: 1650 DUNLAWTON AVE
    PORT ORANGE, FL
    ZIP 32127
  • Facility Phone: 386 322-3267
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MINU GEORGE
  • NPI Number: 1093720211
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2012355
LAB Type Pharmacy
Facility Name WALGREENS CO
Street 1650 DUNLAWTON AVE
City PORT ORANGE
State FL
ZIP 32127
Phone 386 322-3267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director MINU GEORGE

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This page was last updated on: 9/29/2025